1例替加环素致患者急性胰腺炎的临床分析

Clinical Analysis of One Patient with Acute Pancreatitis Induced by Tigecycline

目的:分析在使用替加环素治疗期间患者出现急性胰腺炎的临床特点和相关病因,为替加环素的安全使用提供参考。方法:1例间质性肺炎合并感染患者在使用替加环素和美罗培南抗感染治疗过程中出现上腹部压痛和淀粉酶异常,且B超显示胆囊胆泥淤积和胰腺显示不清,遂请消化科医生会诊,考虑为急性胰腺炎。结果:临床药师综合患者的既往病史和当前用药情况,认为患者的急性胰腺炎可能为替加环素所致,遂建议医生停用替加环素,并开展对症治疗;停药第2天,患者的上腹部压痛较前减轻,淀粉酶水平亦明显下降。结论:临床药师在开展药学实践时,面对患者的突发病症应当综合考虑患者的既往病史和用药情况,对可疑药物加强分析和监测,积极帮助医生寻找可能的病原,保障患者的用药安全。

Objective:To analyze the clinical characteristics and related causes of acute pancreatitis in one patient during the treatment with tigecycline,so as to provide reference for the safety use of tigecycline.Methods:One patient with interstitial pneumonia complicated with infection had epigastric tenderness and amylase abnormalities during the anti-infective treatment with tigecycline and meropenem,and the B-ultrasound showed gallbladder cholestasis and unclear pancreas;so the doctors from Department of Gastroenterology were asked for consultation,and the patient was considered to have acute pancreatitis.Results:Based on the patient's past medical history and current medications,the clinical pharmacist considered that the patient's acute pancreatitis might be caused by tigecycline,and suggested that the doctors stopped the treatment with tigecycline and carried out the symptomatic treatment;on the second day after drug withdrawal,the patient's epigastric tenderness was alleviated,and the amylase level also decreased remarkably.Conclusion:When clinical pharmacists carry out pharmaceutical practices,they should comprehensively consider the patient's past medical history and medications in case of any sudden illness,strengthen the analysis and monitoring of suspicious drugs,actively assist doctors in identifying the possible causes of disease,and guarantee the patient's medication safety.